Adult ADHD Linked to Severe Eating Disorders

Adult ADHD is the general term for cases of the childhood condition attention-deficit hyperactivity disorder that continue to produce significant symptoms in adulthood. Modern studies indicate that 30 percent to 60 percent of children with ADHD also experience the adult form of the disorder. According to the results of a new study published in July 2013 in the journal BMC Psychiatry, people with adult ADHD can develop unusually severe cases of several mental health conditions classified as eating disorders, including bulimia nervosa, binge-eating disorder and unspecified feeding or eating disorder.Adult ADHD Basics ADHD never begins in adulthood. Instead, according to updated guidelines released in 2013 by the American Psychiatric Association (APA), the condition begins sometime before the age of 12 and—at least in some instances—continues to produce its effects in adult life. Doctors typically diagnose the disorder during childhood, but it can also go undetected until childhood has ended. Fewer than 1 in 5 adults affected by ADHD receives an appropriate diagnosis, the Anxiety and Depression Association of America reports. Of those who do receive a diagnosis, only roughly 25 percent seek appropriate treatment. Like children with ADHD, affected adults may experience symptoms of unusual hyperactivity/impulsivity, have an unusual inability to maintain focus or attention, or experience mixed symptoms of both hyperactivity/impulsivity and inattention. However, symptoms of hyperactivity frequently diminish or fade away entirely in adults, and symptoms related to impulsive behavior or inattention tend to predominate. Children diagnosed with the disorder must experience at least six symptoms of hyperactivity/impulsivity, at least six symptoms of inattention, or six symptoms each of both hyperactivity/impulsivity and inattention. However, adults must only experience five or more symptoms of either subtype (or a combination of five or more symptoms from each subtype) for a diagnosis. Eating Disorder Basics The American Psychiatric Association places eating disorders in the same category with a group of conditions called feeding disorders. The classic eating disorders are anorexia nervosa and bulimia nervosa; a third condition, called binge-eating disorder, received official APA recognition in 2013. The other illnesses classified as feeding and eating disorders are rumination disorder, avoidant/restrictive food intake disorder, and pica. In addition to these named disorders, the category includes two less strictly defined conditions called unspecified feeding or eating disorder and “other” specified feeding or eating disorder. People with unspecified feeding or eating disorder have significant symptoms that don’t meet the requirements for diagnosing any other feeding and eating disorder. Adult ADHD’s Impact In the study published in BMC Psychiatry, a multinational European research team examined the effects of adult ADHD on 191 women previously diagnosed with an eating disorder. After reviewing their findings, the authors of the study concluded that the presence of adult ADHD is meaningfully associated with the presence of relatively severe cases of bulimia and binge-eating disorder, as well as certain relatively severe cases of unspecified feeding or eating disorder (known in the study as unspecific eating disorder). However, adult ADHD is not associated with the classic form of anorexia, which produces a highly restrictive pattern of eating. The underlying link between adult ADHD and bulimia, binge-eating disorder, and unspecified feeding or eating disorder is apparently the high level of impulsive behavior that commonly manifests in adults affected by ADHD. In particular, this impulsivity can facilitate the periodic eating binges that characterize both bulimia and binge-eating disorder, and also sometimes occur in people with an unspecified eating disorder. Advancing age worsens the impact of impulsivity, and it is the combination of age and impulsivity that makes adult ADHD a powerful potential contributor to disordered eating. The presence of unusual impulsivity also diminishes the ability to establish and complete any type of goal that requires more than short-term effort. Crucially, the impaired ability to create and carry out plans makes it significantly more difficult for adults affected by ADHD to stick to the treatments required to deal with eating disorders. Significance The authors of the study in BMC Psychiatry believe that their findings will make it easier for mental health professionals to recognize and account for the impact of adult ADHD on people diagnosed with bulimia, binge-eating disorder, or unspecified feeding or eating disorder. They also believe that their findings will make it easier for future researchers to map out the changes in brain function that contribute to both eating disorders and various forms of dependence or addiction.